The protective role of metformin against severe dengue disease in patients with type 2 diabetes mellitus: a preliminary report in Mexico

doi:10.5847/wjem.j.1920-8642.2025.105

World Journal of Emergency Medicine ›› 2025, Vol. 16 ›› Issue (6): 586-592.doi: 10.5847/wjem.j.1920-8642.2025.105

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The protective role of metformin against severe dengue disease in patients with type 2 diabetes mellitus: a preliminary report in Mexico Open Access

José Manuel Reyes-Ruiz¹(), Rosa María Del Ángel²(), Carlos Noe Farfan-Morales³, Carlos Daniel Cordero-Rivera², Luis Adrián De Jesús-González⁴, Selvin Noé Palacios-Rápalo⁵, Juan Fidel Osuna-Ramos⁶, Gustavo Martínez-Mier¹, Noel Jhosimar Sánchez-Jiménez¹, Víctor Bernal-Dolores¹, Sergio Arturo García-Grajales¹, Iván Sandoval-Guzmán¹, Karem Samantha González-Medel¹

¹High Specialty Medical Unit, Specialty Hospital No. 14, Adolfo Ruiz Cortines National Medical Center, Mexican Social Security Institute (IMSS), Veracruz 91897, Mexico
²Center for Research and Advanced Studies (CINVESTAV-IPN), Mexico City 07360, Mexico
³Department of Natural Sciences, Autonomous Metropolitan University (UAM), Cuajimalpa Campus, Mexico City 05348, Mexico
⁴Zacatecas Biomedical Research Unit, Mexican Social Security Institute, Zacatecas 98000, Mexico
⁵Pasteur Institute, Structural Virology Unit, Paris 75015, France
⁶School of Medicine, Autonomous University of Sinaloa, Culiacán 80019, Mexico

Received:2025-03-29 Accepted:2025-07-02 Online:2025-11-13 Published:2025-11-01
Contact: José Manuel Reyes-Ruiz, Email: jose.reyesr@imss.gob.mx
Rosa María Del Ángel, Email: rmangel@cinvestav.mx;

1. Supplementary figure 1.docx(607KB)

Abstract

José Manuel Reyes-Ruiz, Rosa María Del Ángel, Carlos Noe Farfan-Morales, Carlos Daniel Cordero-Rivera, Luis Adrián De Jesús-González, Selvin Noé Palacios-Rápalo, Juan Fidel Osuna-Ramos, Gustavo Martínez-Mier, Noel Jhosimar Sánchez-Jiménez, Víctor Bernal-Dolores, Sergio Arturo García-Grajales, Iván Sandoval-Guzmán, Karem Samantha González-Medel. The protective role of metformin against severe dengue disease in patients with type 2 diabetes mellitus: a preliminary report in Mexico[J]. World Journal of Emergency Medicine, 2025, 16(6): 586-592.

Figures/Tables 3

Table 1

Patients demographics and baseline clinical characteristics

Variables	All patients (n= 68)	Metformin non-users (n= 28)	Metformin users (n= 40)	P-value
Age, years	60.53 ±13.78	60.79 ±15.27	60.35 ±12.83	0.722
Female sex, n (%)	29 (42.6%)	11 ( 39.3%)	18 (45.0%)	0.804
BMI, kg/m²	29.16 ±4.87	29.58 ±5.15	28.86 ±4.70	0.521
Obesity (≥30 kg/m²)	26 (38.2%)	12 (42.9%)	14 (35.0%)	0.614
Hypertension, n (%)	24 (35.3%)	12 (42.9%)	12 (30.0%)	0.311
Nephropathy, n (%)	2 (2.9%)	1 (3.6%)	1 (2.5%)	1
Severe dengue, n (%)	14 (20.6%)	11 (39.3%)	3 (7.5%)	0.002
Dengue virus Serotype 2 Serotype 3	17 (25.0%) 51 (75.0%)	6 (21.4%) 22 (78.6%)	11 (27.5%) 29 (72.5%)	0.777
Days of hospitalization	3.5 (2)	3.5 (3)	3.5 (2)	0.608
Hemoglobin, g/dL	14 (2.0)	13.65 (2.2)	14.9 (1.7)	0.010
HbA1c >8.0% (unacceptable), n (%)	11 (16.17%)	4 (14.3%)	7 (17.5%)	1
Hematocrit, %	41.2 (10)	38.55 (14.2)	43.45 (8.3)	0.062
MCV, fL	88 (4.3)	88 (4.6)	88 (5.9)	0.493
MCH, pg	29 (4.2)	29.6 (4.1)	28.8 (3.9)	0.139
Leukocytes, ×10⁹/L	6.8 (4.27)	6.65 (5.46)	7.07 (3.55)	0.754
Neutrophils, ×10⁹/L	3.6 (3.24)	3.90 (3.56)	3.47 (3.29)	0.620
Lymphocytes, ×10⁹/L	0.61 (0.46)	0.68 (0.47)	0.61 (0.40)	0.242
Monocytes, ×10⁹/L	0.38 (0.31)	0.38 (0.43)	0.38 (0.23)	0.706
Platelets, ×10⁹/L	75 (39)	79.5 (51)	79 (44)	0.813
AST, U/L	80 (97)	66 (50)	120 (102)	0.014
ALT, U/L	60 (43.8)	42.5 (40.8)	71 (72.0)	0.053
Albumin, g/dL	3.71±0.76	3.7 ±0.62	3.66 ±0.84	0.698
Glucose, mg/dL	119.5 (87.0)	116 (82.5)	156.5 (89.8)	0.188
Urea, mg/dL	26.1 (37.25)	28.75 (50.22)	25.3 (28.17)	0.048
Creatinine, mg/dL	0.84 (0.38)	0.96 (1.16)	0.8 (0.36)	0.034
Creatinine >2 mg/dL, n (%)	10 (14.7%)	7 (25%)	3 (7.5%)	0.079
LDH, U/L	258 (140.5)	208 (100.5)	268.5 (164.25)	0.398
Cholesterol, mg/dL	162.16 ±44.83	155.24 ±32.25	166.99 ±51.72	0.287
Triglycerides, mg/dL	131.5 (66.75)	137.25 (54.22)	131.5 (80.75)	0.778
Hyperlipidemia, n (%)	11 (16.2%)	3 (10.7%)	8 (20.0%)	0.505
Insulin, n (%)	10 (14.7%)	6 (21.4%)	4 (10.0%)	0.297
Sitagliptin, n (%)	20 (29.4%)	15 (53.6%)	5 (12.5%)	0.0003
Statins, n (%)	13 (19.1%)	7 (25.0%)	6 (15.0%)	0.357

Table 1

Figure 1.

Table 2

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Patients	Severe dengue n (%)	Crude RR (95% CI)	P-value	Adjusted RR^a (95% CI)	P-value	Adjusted RR^b (95% CI)	P-value
Metformin non-users (n=28)	11 (39.28)	1.00		1.00		1.00
Metformin users (n=40)	3 (7.5)	0.19 (0.05-0.62)	0.006	0.20 (0.06-0.68)	0.010	0.12 (0.04-0.36)	0.0001

The protective role of metformin against severe dengue disease in patients with type 2 diabetes mellitus: a preliminary report in Mexico Open Access

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